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Monday was my final final final *crossing my fingers* surgery. Going into it, I felt a little like Veruca Salt. “I want perfect boobs Dr. Festekjian and I want them NOW!” “Festekjian…how much do you want for the perfect boobs? Name your price!” (I guess the answer to that will be arriving after the insurance adjustment in a few weeks!)

But really though. I did feel a bit…oh what should I say…spoiled? After all, I emerged from November’s implant exchange surgery with a pretty decent rack. After the swelling went down and I let things settle in for a month or two, I realized they were a good size and shape. But they weren’t perfect. And perfect is what I wanted, because, well–why not? After all of this–a mastectomy and an infection and reconstruction and all of these surgeries in the name of not getting breast cancer–I might as well get exactly what I want.

The main problems were the unevenness in nipple height and the rippling on the right side. But even the week before the surgery, when I sent an updated photo to a blog follower, she said they looked great and she thought I had already had the surgery to adjust the nipple height! For a moment there I considered canceling the surgery because I didn’t want to push my luck.

But…obviously I didn’t cancel it, and I’m sure glad I didn’t.

Per my usual routine, I spent all of Sunday chugging water like a crazy person to prepare my tiny veins to be poked and prodded. My mom picked me up from my apartment at 6:00 am on Monday morning. Jeani, bless her heart, had scheduled me for the earliest appointment because of the snafu that happened last time.

I checked in at the outpatient surgery center, changed into the sexy hospital gown and matching accessories, then chatted with a nurse. It’s kind of strange when you start to recognize the doctors and nurses…I’m pretty sure this particular nurse, who has been a vegan for over twenty years and always eats salad for lunch, has checked me in three times.

The most miraculous thing happened next. Brace yourself, because what you are about to read may rock your world and make you question everything you know.

A nurse anesthetist came in to talk to me about the anesthesia cocktail and start my IV. She was young, kind…unassuming. Little did I know of the POWERS SHE POSSESSED.

As is custom, my mom and I launched into our tirade about my horrible veins and the atrocities that have befallen me at the hands of IV nurses and anesthesia doctors alike in the walls of the UCLA Medical Center: the constant pokes, the unyielding veins, the need to “call in the big guns” and of course, the multiple PICC lines.

UNSCATHED by these warnings, the young nurse did persist with a smile. “I’ll have to numb you up then!” Haha, you fool! Numbing medicine will do nothing but make my uncooperative veins further retreat into the depths of my wrist/hand/arm/foot/every other part of my body, I mused as she left the room.

Moments later she returned carrying a tiny needle and an IV kit. As she stationed herself to my left, the noble Dr. Festekjian appeared, clad in a red track jacket. As we exchanged the standard hellos, the young nurse poked me with the numbing needle, warning me of a slight sting. “‘Twas nothing”, I murmured.

Then she started the long, daunting process of stabbing me with the IV needle to find a vein. I settled in for the long haul, turning my attention to Dr. Festekjian, when suddenly…within seconds…the voice of an angel rang out.

“All done! Your IV is started.”

A MIRACLE. It took her only ONE TRY, only ONE MEASLY POKE, to start my IV. I wanted to hug her, become her best friend, then follow her around from place to place for the rest of my life so she can always be the one to start my IV.

I was giddy with excitement at this point, but tried to remain steady while Dr. Festekjian played Connect the Dots on my chest with the pretty sterile pen. I figured that if I moved too much and the lines were uneven, it would be my own damn fault if my nips still looked lopsided.

A few minutes later the happy drugs were put into my IV, I was wheeled into the operating room, and then I was out. By 10 am I was awake in the recovery room, and I was discharged by 10:30 am.

Wisely, Dr. Festekjian warned my mom that I would be very bruised and very swollen for a while, possibly with some dimpling. I’m sure he was hoping to avoid the “WTF!” email he received last time. Even with the painkillers, I could definitely feel a dull soreness on my right side where he did all of the work. Even the arm fat near my armpit was super bruised.

I stayed home from work yesterday and today and took a shower this morning. I’m on antibiotics for a few days, and I’m definitely swollen; my right breast looks about one cup size bigger than the left breast, like I have a 1000 cc implant in there instead of 800 cc. And there is certainly some dimpling, mainly where the stitches are holding the skin up. But the nipples sure seem even and the alloderm seems to have gotten rid of the rippling, so I can’t wait to see how they look in a week or two!

My post-op with Dr. Festekjian is on Tuesday morning. I feel okay right now, still a bit sore, but I’ll be returning to work tomorrow. I did go on an hour-long walk this evening to stretch my legs, and that felt great. Hopefully I’ll get permission to head back to the gym next week. Interestingly enough, I am using my pit pillow again. It works well to support my arm when I’m on my computer and when I’m sleeping. Thanks again to my friend Kim who originally introduced me and my mom to pit pillows!

Pictures soon. Right now I’ve got them tucked up nicely in a sports bra so I don’t really feel like digging them out of there.

Instead, I leave you with a photo of the Chester Bug, keeping me company while I worked from home today. Isn’t he just the cutest little kitten? (Yes. I’m that person now. #instacat #catstagram #ilovemycat.)

Yesterday I went to my 3 pm tissue expander fill at Dr. Festekjian’s office, which I was pretty sure would not actually be a fill since my left breast looked so swollen and red. Maria looked at it and agreed that Dr. Festekjian should definitely check it out. He came in, asked me about the time frame of what happened (I slept on my tissue expanders on Saturday night, felt pain on Sunday morning, etc.), and then examined the area. He then looked at me and said, “You have to go to the hospital.”

For a second there I wasn’t sure if he was trying to like, joke with me or something. I just kind of stared at him. He didn’t ask any questions or do any tests, just–“hospital!”

Then I started to get pretty upset. He mentioned the word “cellulitis” and said that I needed to get an IV with some heavy antibiotics. I asked him how often he sees this; he said each year, typically three or four patients will have cellulitis after a mastectomy…which is out of about 140 mastectomy patients. SWEET. Of course it would happen to me, the “young and healthy” patient.

He said he would take care of the arrangements to get me admitted next door at Ronald Reagan UCLA Medical Center (the hospital portion). After about 15 minutes, Maria came into the room and told me they were ready for me at admissions.

Now it’s lucky, I guess, that I am constantly driving from home to home (my apartment, my parents’ place, Bryce’s house) and half of my life is in my car. We walked down there and I was able to grab my laptop and charger as well as some clean clothes. The car itself presented a new problem: what was I supposed to do with it? UCLA is not very flexible with their patients when it comes to parking. Maria said I could leave my car there overnight, but unless someone took it out of the parking garage, went back in to get a new ticket, and parked in a new spot, I would get a parking ticket. Luckily my friend Kate said she’d help figure out the parking situation.

As we walked over to the hospital, I asked Maria what the next few days would be like. She said I should expect to be at the hospital for the entire weekend since Dr. Festekjian would be the one to make the ultimate decision to discharge me. She explained that over the course of the next few days, I would be given an IV drip of antibiotics in order to try to fight a broad range of bacteria (cellulitis, I’ve since learned, is just the name for a general bacterial skin infection.) If the antibiotics work successfully, the area will be monitored and given a few weeks to rest before my tissue expander fills continue.

If the antibiotics don’t work…well, this is the fun part of which I am really terrified: the tissue expander will be removed for at least two or three months.

I think we can all agree that the latter option sounds awful. Given those two choices, I definitely support the IV antibiotics route! (Though it’s not like I have an actual say in this…what Festekjian wants, Festekjian gets.)

Around 4:15 pm I completed admissions papers at Ronald Reagan UCLA Medical Center. I was finally assigned a room on the sixth floor (6347 West) around 5:00 pm. There’s a view of UCLA’s football field, and I can see the helipad–pretty cool.

To the left is the UCLA football field; to the top right is the helipad.

For the next few hours, I sat around…doing nothing. My lovely roomie Danielle showed up around 6 pm with salads and GIANT chocolate chip cookies. I was ravenous, and that meal hit the spot!

Someone came in to draw blood around 6:30 pm. FAIL. My veins are awful, I know. Everyone tells me how nonexistent they are. In the past, however, I’ve never actually had a problem getting blood drawn. He stabbed my left arm and a few minutes later dumped the vials into the toxic waste bin, saying “I’ll have to call in someone else.” He hadn’t gotten any blood!

I started chugging water. This was my first “surprise” blood test; usually I know it’s coming so I drink a lot of water the day before and morning of in order to plump up my veins.

Another woman came in about twenty minutes later. She continued to poke and prod me, looking for a good vein. Nope.

Bryce and his mom showed up later in the evening, which was a pleasant surprise. I had told Bryce not to worry about visiting me the first night since he was planning on spending the night at the hospital on Friday. My friend Kate, who goes to UCLA, also dropped by…with snacks and tampons! AND she was able to find a parking spot for my car–what a lifesaver!

Another phlebotomy specialist came in. He looked much more serious than the first two…he meant business! I explained that I really hated needles and would appreciate if he could apply some numbing cream before poking me. He spent a good deal of time lifting up my arms and using a tourniquet to try to find a vein. Finally he settled on a vein on the side of my left wrist. He applied the cream, and about fifteen minutes later, stuck in the needle. And…there was nothing. He poked around with the needle, trying to strike gold with a vein. NOPE.

He had to call in the big guns: an ICU nurse. Together, they poked and prodded even more. Finally, the ICU nurse (who was hilarious, by the way; a Londoner who my dad would have loved) zeroed in on a vein in the elbow crevice of my right arm. He slapped at it for a good three minutes, and as soon as it popped up again, he went for it…and there was success! We all clapped. At least not all of the efforts were in vain! (…pun…hahaha)

They took two vials of blood and also used that area for my IV port. Around 10 pm my nurse hooked up the antibiotics to the IV. Finally, treatment!

I know one of the antibiotics was Vancomycin, and boy, did it make my head itch!!! I learned online that an itching scalp is a common reaction from Vancomycin and that Benadryl should help it. My nurse injected some Benadryl into my IV, the itching stopped, and I finally got to sleep.

Members of the plastic surgery team (Maria included) woke me up bright and early at 7 am today. I don’t know when they arrived at work, but I’m still amazed at how happy and put-together they all were. Give me a break! I’m lying in bed with hair like Einstein’s from all of the itching, and then these beautiful, smiling people suddenly surround me. It was a sneak attack!

Maria checked on my left breast and said that it already looked to be improving. YES!

Cellulitis, you are EVIL. I need to do more research on the topic, but I’ve gathered the following from WebMD:

“Cellulitis is a skin infection caused by bacteria. Normally, your skin helps protect you from infection. But if you have a cut, sore, or insect bite, bacteria can get into the skin and spread to deeper tissues. If it is not treated with antibiotics, the infection can spread to the blood or lymph nodes. This can be deadly.”

“At first, the infected area will be warm, red, swollen, and tender. As the infection spreads, you may have a fever, chills, and swollen glands.”

Well, that all sounds accurate to me: I had a major surgery involving a cut, the area is definitely red and swollen, and I really started to feel sick when I developed a fever.

Today I will have an ultrasound of my left breast to make sure there isn’t any fluid buildup. If there is, it will need to be drained. Fingers crossed there’s no fluid!

Well, that’s it for now. My nurse just started another IV drip. Check back for more updates on Cellulitis 2012!

Hi, I'm Rachel, your average twentysomething. I'm in a sorority, I just graduated from college and started my first full-time job, and oh yeah, I recently had a double mastectomy! Welcome to my world of BRCA genes, plastic surgery, and snap-in-front bras.

Looking for gifts for mastectomy patients? Check out Precious Survivors for mastectomy pit pillows and other gifts. A portion of the proceeds benefits breast cancer previvor and survivor organizations.